The Matriarch Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE MATRIARCH CLINIC

Practice address

62 Tillyfour Rd
Bozeman, MT 59718-9666

Phone

(406) 414-0020

Fax

(888) 289-4505

NPI assigned

Mar 6, 2024

Last updated

Mar 6, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amy Michele Enterline Consson, MDNPI 1851704936

Title

Owner

Phone

(406) 606-0332

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Michele Enterline Consson, MD

  • Internal Medicine Physician
  • Bozeman, MT
  • NPI 1851704936
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1366200206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 MAX AVE # 1187",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187143",
            "telephone_number": "406-414-0020",
            "fax_number": "888-289-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 TILLYFOUR RD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189666",
            "telephone_number": "406-414-0020",
            "fax_number": "888-289-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MATRIARCH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "CONSSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "MICHELE ENTERLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-606-0332",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Internal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.